Image Credit: Twin Pregnancy and Beyond
I will be the first to admit that, despite my best efforts, my children had speech development issues. Between the ages of 2 and 3, I just knew in my gut something was off with them. At their 3 year appointment, our pediatrician agreed and we went for a consultation with a speech language pathologist (SLP). Both kids were tested and both came back with opposite results. Aaron’s speech was fine, however, he talked entirely too fast. The SLP would turn the page in the book they were using and he would be done before the page was completely turned. Jillian, on the other hand, was delayed. She wasn’t delayed to the point that they thought therapy was needed, but there was something there. What we ended up learning was that Aaron did the majority of the talking and often times spoke for Jill. After spending some time in a classroom setting her speech improved leaps and bounds. Scott and I have had to make a conscious effort to specifically wait for Jill to answer questions, and really work with her on her speech. We’ve also had to work with Aaron and getting him to slow down, something I’m afraid he may have gotten from me (I talk super fast).
I thought it was best to tell you my experience with speech development before getting to the experts. Sometimes we need to hear that someone else is going through a similar situation before reading what an expert has to say about it.
When it comes to speech development and delays, the main question I’ve come across is, “How do I know they have a speech delay? What are the warning signs?” According to MaryFrances Gonzalez MA CCC-SLP, a licensed & certified Speech Language Pathologist and Founder of TeachSpeech, LLC, some common “warning signs” are:
-No babbling by 9 months.
-No first words by 15 months.
-No consistent words by 18 months.
-No word combinations by 24 months.
-Slowed or stagnant speech development.
-Problems understanding your child’s speech at 24 months of age; strangers having problems understanding your child’s speech by 36 months of age.
-Not showing an interest in communicating.
-Failure to respond normally, such as not responding when spoken to. This may include signs that the child does not hear well, such as not reacting to loud noises.
-A sudden loss of speech and language skills. Loss of abilities at any age should be addressed immediately.
-Not speaking clearly or well by age 3
It is important that every parent understand that each child is unique in their development much like in their personality. Language milestones are only guidelines for determining what a child should be doing at each age. Children will meet milestones at different times and a delay in reaching a milestone is only part of the equation when evaluating whether a child may have a speech or language delay.
While working on this topic I found myself wondering if being a multiple would increase the likelihood of speech delays. After all, in my situation, Jill’s delay was due in part to her brother speaking for her. Beyond Baby Talk 2 authors and American Speech-Language-Hearing Association (ASHA) members Kenn Apel and Julie Masterson suggested that multiples may lag behind single-birth children in their speech and language development, but the key word there is “may.” Some delay might be expected due to biological or medical reasons associated with the multiple birth (e.g., premature birth), although if one calculates age based on the expected full-term due date, often, the delay is not really a delay. Nevertheless, some multiples may demonstrate delays even with the recalculation of age. Some experts have suggested delays are due to less one-to-one child-adult time, resulting in less adult speech/language models, although, frankly, the same could be said for children who are third or fourth born in large families. The bottom line answer is that if multiples are delayed in their speech and language skills, the type of delay is not necessarily any different than any other children’s delays. And the type of help they need does not differ from the help any child would need.
MaryFrances agrees saying that, within the last decade, twin and multiple births have increased. This has sparked more focused research and interesting findings on twin language development. For example, research has demonstrated that being a twin or multiple does not necessarily increase the likelihood of a language delay but rather the combination of several factors such as perinatal (premature birth, low birth weight), environmental (simultaneously caring for two or more babies with the same needs), and social factors (less individual talk time and shorter individual attention) can play a large role in potential language delay.
Now, what if you think your child, or children, have a delay? When should you seek the help of a speech language pathologist? All of the experts are in agreement that you as a parent should go with your gut. If you are concerned about a delay, you should go ahead and seek expert advice. For example, children should be using a variety of single words by the time they are 15 to 18 months old. If they are not doing this, a speech-language pathologist can evaluate the children and decide to (a) work with the children and the parents, (b) coach the parents in strategies to increase the children’s language, or (c) use a “watch and see” approach and monitor the development to make sure adequate progress is occurring. For help locating a speech language pathologist in your area, you can go to ASHA’s website (www.asha.org) or call 800-638-8255. Additionally, services are available through the Early Intervention Program (Birth to 3 years) and Public School System (3 to 21 years) in your state.
There are also a bunch of activities you can do with your kiddos if you feel there is a speech delay, or if you already know there is one. Rose Godfrey , MA , CCC told me that reading to a child is a great way to improve language skills. Start with picture books, naming things over and over and over and…..move onto stories that have a predictable sequence and/or repetitive phrasing (I’ll huff, and I’ll puff, and I’ll blow your house down). There is a good reason the classics are classic. If you aren’t sure which books to pick, choose the tried and true classics that have been popular forever. Rhymes and fingerplays are good as children move into toddlerhood. Rhyming ability is linked to later spelling ability, so silly poems are a great way to have fun and build skills.
Get down on a child’s level, play on the floor. Sometimes one child will talk for another (very common for older siblings to do this for younger, but also happens with multiples). Usually the kid who isn’t doing the talking gets fed up when the talker gets it wrong and that takes care of that, but if it looks like one child is developing significantly ahead of the other, that would also be of concern.
MaryFrances says that the best thing parents can do is TALK with their child, PLAY with their child, and READ to their child. Daily routines such as mealtimes, bath time, changing times, and car rides are excellent opportunities to encourage language learning. Not only are these routines predictable and repetitive, which aids in retention, but also it is direct one-on-one time with a parent. Parents can teach new words, make funny sounds, describe what they are doing, or talk about what their child is doing.
With multiples, it can be quite challenging to find individual time with each child. Enlist family members so that is possible, utilize daily routines (you can’t change two diapers at a time) for talking/listening time, and attend play groups in your area so that your multiples have other peer language models.
Although your twins/multiples arrived as a team, they are individuals. It is important to verbally address each child individually and not generally such as when applying praise and positive reinforcement. When the children begin speaking, do not allow for one child to be the spokesperson for the other(s). Taking turns talking, listening, and responding are all part of the communication process and should be encouraged by parents.
I think the biggest take-away from this article is that if you feel in your gut that one or more of your multiples has a speech delay, find a speech language pathologist in your area to have them evaluated.
Let’s keep the discussion going on here. Did any of your children have speech delays? What was the process like for you and what tips do you have for families in a similar situation?
About our experts:
MaryFrances Gonzalez MA CCC-SLP, is a licensed & certified Speech Language Pathologist and Founder of TeachSpeech, LLC- a private speech & occupational therapy practice in Northern Virginia specializing in Early Intervention. Visit her website http://www.teachspeechtherapy.com and sign up for the new Speech & Outreach Blog which was created help educate families about early speech & language development.
Kenn Apel, PhD, CCC-SLP, is professor and chair of Communication Sciences and Disorders at the University of South Carolina and a widely-known researcher and educator in language and literacy development and disorders.
Julie J. Masterson, PhD, CCC-SLP, is a nationally-known educator and researcher in speech, language, and literacy development. She is professor of Communication Sciences and Disorders at Missouri State University.
Rose Godfrey, MA, CCC is licensed as a speech-language pathologist by the State of California Speech Language Pathology and Audiology Board.
Rose earned her Bachelor’s degree at Oklahoma State University in 1989 and her Master’s degree at California State University , Chico in 1991. She holds the Certificate of Clinical Competence from the American Speech-Language-Hearing Association and the California Speech and Hearing Association.
In addition to working as a speech-language pathologist, Rose writes Learning at Home, a column about home education for the Appeal-Democrat newspaper in Marysville , CA . She has also authored two books, Don’t Put Headphones on the Cat and The Pig in the Pantry and Other Homeschool Tales.
In her free time, Rose enjoys reading, traveling, and going out with the family for wild mountain blackberry ice cream on a sugar cone.